Charles Cevallos, D.O

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

OS16582 Issued in FL

Practice address

1600 S Andrews Ave
Ft Lauderdale, FL 33316-2510

Phone

(954) 355-3478

NPI assigned

Feb 1, 2017

Last updated

Jun 1, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Cardiovascular Disease (Cardiology)

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Manatee Memorial Hospital L PGroup PAC ID 2062309164, 37 clinicians

Manatee Cardiology Associates LLCGroup PAC ID 9133377500, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Manatee Memorial Hospital Hospital, Bradenton, FL, CCN 100035
• Lakewood Ranch Medical Center Hospital, Bradenton, FL, CCN 100299
• Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1685

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Manatee Cardiology Associates, LLC

  • Cardiovascular Disease Physician
  • Bradenton, FL
  • NPI 1720341068
  Medicare reassignment Care Compare group NPD
• Manatee Memorial Hospital L P

  dba Manatee Memorial Hospital

  • Other Specialist/Technologist
  • Bradenton, FL
  • NPI 1770505687
  Medicare reassignment Care Compare group NPD
• Manatee Memorial Hospital L P

  dba Manatee Diagnostic Center

  • Radiology Clinic/Center
  • Bradenton, FL
  • NPI 1558020552
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lakewood Ranch Medical Center

  • General Acute Care Hospital
  • Bradenton, FL
  • NPI 1730179714
  Care Compare affiliation
• Manatee Memorial Hospital L P

  dba Manatee Memorial Hospital

  • General Acute Care Hospital
  • Bradenton, FL
  • NPI 1760472799
  Care Compare affiliation
• Sarasota County Public Hospital District

  dba Sarasota Memorial Hospital

  • General Acute Care Hospital
  • Sarasota, FL
  • NPI 1245294826
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1346788155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S ANDREWS AVE",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162510",
            "telephone_number": "954-355-3478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S ANDREWS AVE",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162510",
            "telephone_number": "954-355-3478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5433 SW 186th Way",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330296256",
            "country_code": "US",
            "telephone_number": "954-235-3961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CEVALLOS",
        "first_name": "CHARLES",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-01",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "UO3899",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "UO3899",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "OS16582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Certified Foot & Ankle Specialists
• Certified Foot & Ankle Specialists (Multi-Specialty Physician Services)
• Certified Therapy Group Inc
• Anthony Cespedes Olivences
• Nicole Ceusters, MS, LMHC
• Analyn Orillaza Cezar, PT
• Cfsatc, Inc. (Central Florida Treatment Center Fort Lauderdale)
• Ashley H Chabaud
• Kennedi Alexis Chadwrick
• Susana Chagui, APRN

• Cardiovascular Disease Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Cardiovascular Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.